House GOP documents outline plan to replace Obamacare

House Republicans hope to phase out Medicaid expansion as part of a plan to repeal and replace the Affordable Care Act, according to policy documents distributed by House GOP leaders to their membership Thursday.

The two documents are outlines of an initial approach by House Republicans and are the first printed summaries of a GOP health care plan since the election of President Trump.

They include a PowerPoint presentation with messaging recommendations and a 19-page paper that outlines the direction Republicans hope to take with new health care legislation. Both were crafted and agreed upon by House Republican leadership and the two committee chairmen who are charged with replacing the ACA: Reps. Kevin Brady, R-TX, chair of the Ways and Means committee, and Greg Walden, R-Oregon, head of the House Energy and Commerce Committee.

PBS NewsHour obtained the two policy documents from a member of Congress who asked not to be named because the briefings were not meant to be shared publicly.

Details will be debated and fleshed out when committees return at the end of February.

“While we could simply allow the law to collapse, that would not be fair to the American families struggling under Obamacare. The truth is, left unaddressed, the situation would only get worse – with even fewer coverage options and even higher costs,” the memo says.

The 19-page memo describes a repeal-and-replace bill in largely broad terms, leaving out specifics that will be required in final legislation.

But the guide also offers new insight into House Republicans’ vision for the law, such as an apparent decision to phase out the Medicaid expansion under ACA that covered millions of low-income Americans.

“House Republicans agree control should be returned back to states and Washington bureaucrats role in Medicaid reduced,” the document says. “Instead of simply expanding a broken program, Republicans instead want to put states in charge of their Medicaid programs and give them the tools, resources, and flexibility to address their unique needs.”

Under the plan, states that expanded Medicaid under the Affordable Care Act “could continue to receive enhanced federal payments for currently enrolled beneficiaries for a limited period of time,” the memo said.

But states that keep that coverage in place would eventually return to their “traditional match rates,” from the federal government, according to the proposal.

Republicans have been debating whether to continue the Medicaid expansion coverage with some form of block grants, end it suddenly or phase it out over time.

States would have the option to pursue block grants under this latest proposal.

House GOP leaders also sent rank-and-file Republicans a 15-slide Powerpoint presentation highlighting what they called Obamacare’s failures, as well as Republicans’ broad goals in replacing it. It also discusses expanding and enhancing health savings accounts and a monthly tax credit consumers could use to buy an insurance plan not “tied to a job or a government-mandated program.”

The memo said that House Republicans would act to repeal ACA after returning from the President’s Day break.

Left:
The 2,409 pages of H.R. 3590, the Patient Protection and Affordable Care Act, are displayed for a photograph in 2010 in New York. House GOP leaders distributed policy documents this week to their membership outlining their initial approach to repealing and replacing President Obama's health care law. Photo by Daniel Acker/Bloomberg via Getty Images.

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Lisa Desjardins is a correspondent for PBS NewsHour, where she covers news from the U.S. Capitol while also traveling across the country to report on how decisions in Washington affect people where they live and work.